血清OC、25(OH)D及PTH水平与老年骨质疏松患者胸腰椎骨折的关系及其预测价值分析  

Relationship between Serum OC,25(OH)D and PTH Levels and Thoracolumbar Fracture in Elderly Patients with Osteoporosis and Its Predictive Value Analysis

作　　者：张建华 但刚 胡莉娜 陈清红 常凯 ZHANG Jian-hua;DAN Gang;HU Li-na;CHEN Qing-hong;CHANG Kai(Department of Clinical Laboratory,Western Theater General Hospital,Chengdu,Sichuan,610083,China)

机构地区：[1]西部战区总医院检验科,四川成都610083

出　　处：《现代生物医学进展》2023年第18期3499-3503,共5页Progress in Modern Biomedicine

基　　金：四川省自然科学基金项目(2022NSFSC1415)。

摘　　要：目的:研究血清骨钙素(OC)、25-羟基维生素D[25(OH)D]及甲状旁腺激素(PTH)水平与老年骨质疏松患者胸腰椎骨折的关系及其预测价值。方法:选择2019年6月-2022年6月西部战区总医院收治的171例老年骨质疏松患者。将其按照是否出现胸腰椎骨折分成骨折组80例及无骨折组91例。比较两组血清OC、25(OH)D及PTH水平,以单因素、多因素Logistic回归分析明确老年骨质疏松患者胸腰椎骨折的相关影响因素。采用受试者工作特征(ROC)曲线明确血清OC、25(OH)D及PTH水平预测老年骨质疏松患者胸腰椎骨折的效能。结果:骨折组血清OC、25(OH)D水平均低于无骨折组,而PTH水平高于无骨折组(均P<0.05)。经单因素分析发现,年龄、骨质疏松病程及骨质疏松分级均与老年骨质疏松患者胸腰椎骨折有关(均P<0.05)。经多因素Logistic回归分析:年龄≥70岁、骨质疏松病程≥6个月、骨质疏松分级为Ⅲ级以及高PTH水平均是老年骨质疏松患者胸腰椎骨折的危险因素,而高OC、25(OH)D水平均是老年骨质疏松患者胸腰椎骨折的保护性因素(均P<0.05)。经ROC曲线分析发现:血清OC、25(OH)D及PTH水平联合预测老年骨质疏松患者胸腰椎骨折的效能优于上述三项指标单独检测。结论:血清PTH水平升高是老年骨质疏松患者发生胸腰椎骨折的危险因素,而高OC、25(OH)D水平为保护性因素,联合检测三项指标预测老年骨质疏松患者胸腰椎骨折的效能更佳。Objective:To study the relationship between serum osteocalcin(OC),25-hydroxyvitamin D[25(OH)D]and parathyroid hormone(PTH)levels and thoracolumbar fracture in elderly patients with osteoporosis and its predictive value.Methods:A total of 171 elderly patients with osteoporosis admitted to Western Theater General Hospital from June 2019 to June 2022 were selected.They were divided into fracture group(n=80)and non-fracture group(n=91)according to whether there was thoracolumbar fracture or not.The serum levels of OC,25(OH)D and PTH were compared between the two groups.Univariate and multivariate Logistic regression analysis was used to identify the related influencing factors of thoracolumbar fracture in elderly patients with osteoporosis.The receiver operating characteristic(ROC)curve was used to determine the efficacy of serum OC,25(OH)D and PTH levels in predicting thoracolumbar fractures in elderly patients with osteoporosis.Results:The serum OC and 25(OH)D levels in the fracture group were lower than those in the non-fracture group,while the PTH level was higher than that in the non-fracture group(all P<0.05).Univariate analysis showed that age,course of osteoporosis and grade of osteoporosis were associated with thoracolumbar fracture in elderly patients with osteoporosis(all P<0.05).Multivariate Logistic regression analysis showed that age≥70 years,duration of osteoporosis≥6 months,osteoporosis grade II,and high PTH level were risk factors for thoracolumbar fracture in elderly patients with osteoporosis,while high OC and 25(OH)D levels were protective factors for thoracolumbar fracture in elderly patients with osteoporosis(all P<0.05).ROC curve analysis showed that the combination of serum OC,25(OH)D and PTH levels in predicting thoracolumbar fracture in elderly patients with osteoporosis was better than the above three indicators alone.Conclusions:Elevated serum PTH level is a risk factor for thoracolumbar fracture in elderly patients with osteoporosis,while high OC and 25(OH)D levels are protective fact

关 键 词：骨质疏松 胸腰椎骨折 骨钙素 25-羟基维生素D 甲状旁腺激素 预测价值 

分 类 号：R683.1[医药卫生—骨科学]